San Bernardino County, California



Search Client: Search Forms: FFS Admission Bundle-Opens Admission (outpatient):Episode 1= MH Financial- Complete all red areas. Episode # and name will pre-populate.Enter DOB, SS#, Admit date and time (Current)Program: MH FinancialAdmitting Practitioner: Practitioner FFS Admitting (111111)Type of Admission” MH AdmissionLiving Arrangements: unkDemographics:Enter Client Address and Zip codeEducation and Employment StatusSubmitCSI Error will come up- OK, it will be entered after Episode #2Home screen Client Episode: should be show:Click on Add:Admission (Outpatient) opens:Episode 2= = 36A FFS- Complete all red areas. Episode # and name will pre-populate.DOB, SS# will pre-populate from Episode 1Enter Admit date and time (current)Program: (Discipline code)- MD & DO 36A2, Psy.d & PhD=36A3, LCSW=36A4, LMFT=36A5Click OK and continueAdmitting Practitioner: Practitioner FFS Admitting (111111)Type of Admission: MH AdmissionLiving Arrangements: unkDemographics:All RED areas pre-populates: you can other information if you have it.SubmitTakes you to the HOME page:Refresh the Client Episodes: should show 2 episodes.4749800452120Refresh here0Refresh hereTo enter Insurance into MH Financial:Search forms: Financial Eligibility-Double Click on itFinancialHighlight Episode 1 MH Financial:Double click or OK to openOn the left side Click on Guarantor Information:Click Add New ItemGUARANTOR INFORMATION: Complete RED areasGuarantor#-Medi-cal (32765)Customize Guarantor Plan- NOEligibility Verified-NOSUBSCRIBTER INFORMATION:Coverage eff date: 01/01/2017Right side: Subscriber Assignment of Benefits-YESCoordination of Benefits- YESSubscriber Release of Info-YESScroll back to the top of that page and Enter the 2nd Insurance- County (5000)Add New ItemGuarantor #- County MH (5000)Follow the same entries as the 1st insurance on all others.It should now show 2 insurances- Medical and County in this order.Do not submit at this timeClick on GuarantorThe 2 Insurances will show, Click on them in this order to put 32765-Medi-cal 1st and County (5000) 2nd.Submit ................
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